Endoscopic bipolar electrocoagulation: development of a new bipolar coagulator for stopping gastrointestinal bleeding

We have developed an endoscopically deliverable bipolar coagulator with a pair of active bipolar electrodes and tested its efficacy and safety in canine gastric bleeding models. Hemostasis was achieved with a few applications in all "ulcer maker", gastric serosal vessel, mesenteric vessel and endoscopic "hot biopsy" models. Histologically the mean muscular injury was 10.1% in ulcer maker models and 17.1% in hot biopsy models, significantly less than monopolar electrodes. No full thickness injury resulted. Initial clinical trials in 32 patients with upper gastrointestinal bleeding revealed 100% immediate hemostasis; it could stop spurting arterial bleeding. Our bipolar coagulator is a promising addition to the endoscopic hemostatic methods.